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Gender differences in brain reserve

An 18F-FDG PET study in Alzheimer's disease

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Abstract

Background

Neuropathological studies suggest that the association between neurodegenerative brain damage and clinical symptoms may be stronger in women than in men.

Objective

To test the hypothesis that cerebral metabolic deficits due to neurodegeneration are more pronounced in men than in women at the same level of clinical disease severity.

Methods

93 patients with mild Alzheimer's disease (AD; 50 men, 43 women) underwent an extensive clinical and neuropsychological examination and 18F-FDG PET imaging at a university-based outpatient unit for cognitive disorders. An analysis of covariance (with age, total score of the CERAD neuropsychological battery, and years of school education as covariates) was conducted in each study group to identify gender differences in glucose metabolism.

Results

Controlling for age, education, and clinical severity, cortical regions were identified,where glucose metabolism was significantly reduced in men as compared with women. These regions were located in areas typically affected by AD pathology (right inferior frontal, superior temporal and insular cortex, and hippocampus).

Conclusions

These data suggest that the same clinical severity of dementia is associated with greater reductions in cerebral metabolism in men than in women suggesting a greater degree of brain reserve in men.

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References

  1. Barnes LL, Wilson RS, Bienias JL, Schneider JA, Evans DA, Bennett DA (2005) Sex differences in the clinical manifestations of Alzheimer disease pathology. Arch Gen Psychiatry 62:685-91

    Article  PubMed  Google Scholar 

  2. Buckwalter JG, Rizzo AA, McCleary R, Shankle R, Dick M, Henderson VW (1996) Gender comparisons of cognitive performances among vascular dementia, Alzheimer disease, and older adults without dementia. Arch Neurol 53:436-39

    CAS  PubMed  Google Scholar 

  3. Chandler MJ, Lacritz LH,Hynan LS, Barnard HD,Allen G, Deschner M, Weiner MF, Cullum CM (2005) A total score for the CERAD neuropsychological battery. Neurology 65:102-06

    Article  CAS  PubMed  Google Scholar 

  4. de Courten-Myers GM (1999) The human cerebral cortex: gender differences in structure and function. J Neuropathol Exp Neurol 58:217-26

    Article  CAS  PubMed  Google Scholar 

  5. Dekaban A, Sadowsky D (1978) Changes in brain weights during the span of human life: relation of brain weights to body heights and body weights. Ann Neurol 4:345-56

    Article  CAS  PubMed  Google Scholar 

  6. Dilling H, Mombour W, Schmidt MH, Schulte-Markwort E (eds) (1994) Weltgesundheitsorganisation: Internationale Klassifikation psychischer Störungen. ICD-10 Kapitel V(F) Forschungskriterien.Huber, Bern, Göttingen, Toronto, Seattle

  7. Drzezga A, Riemenschneider M, Strassner B, Grimmer T, Peller M, Knoll A, Wagenpfeil S, Minoshima S, Schwaiger M, Kurz A (2005) Cerebral glucose metabolism in patients with AD and different APOE genotypes. Neurology 64:102-07

    CAS  PubMed  Google Scholar 

  8. Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental state".A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189-98

    Article  CAS  PubMed  Google Scholar 

  9. Friston KJ, Frith CD, Liddle PF, Frackowiak RS (1991) Comparing functional (PET) images: the assessment of significant change. J Cereb Blood Flow Metab 11:690-99

    CAS  PubMed  Google Scholar 

  10. Ghebremedhin E, Schultz C, Thal DR, Rub U, Ohm TG, Braak E, Braak H (2001) Gender and age modify the association between APOE and ADrelated neuropathology. Neurology 56:1696-701

    CAS  PubMed  Google Scholar 

  11. Graves AB, Mortimer JA, Larson EB, Wenzlow A, Bowen JD, McCormick WC (1996) Head circumference as a measure of cognitive reserve.Association with severity of impairment in Alzheimer's disease. Br J Psychiatry 169:86-2

    Article  CAS  PubMed  Google Scholar 

  12. Gur RC, Mozley LH, Mozley PD, Resnick SM, Karp JS, Alavi A, Arnold SE, Gur RE (1995) Sex differences in regional cerebral glucose metabolism during a resting state. Science 267:528-31

    Article  CAS  PubMed  Google Scholar 

  13. Herholz K, Salmon E, Perani D, Baron JC, Holthoff V, Frolich L, Schonknecht P, Ito K, Mielke R, Kalbe E, Zundorf G, Delbeuck X, Pelati O, Anchisi D, Fazio F, Kerrouche N, Desgranges B, Eustache F, Beuthien-Baumann B, Menzel C, Schroder J, Kato T, Arahata Y, Henze M, Heiss WD (2002) Discrimination between Alzheimer dementia and controls by automated analysis of multicenter FDG PET. Neuroimage 17:302-16

    Article  CAS  PubMed  Google Scholar 

  14. Katzman R (1993) Education and the prevalence of dementia and Alzheimer's disease. Neurology 43:13-0

    CAS  PubMed  Google Scholar 

  15. Kawachi T, Ishii K, Sakamoto S, Matsui M, Mori T, Sasaki M (2002) Gender differences in cerebral glucose metabolism: a PET study. J Neurol Sci 199:79-3

    Article  CAS  PubMed  Google Scholar 

  16. Loring DW, Meador KJ, Allison JD, Pillai JJ, Lavin T, Lee GP, Balan A, Dave V (2002) Now you see it, now you don't: statistical and methodological considerations in fMRI. Epilepsy Behav 3:539-47

    Article  PubMed  Google Scholar 

  17. Mascagni JR, Miller LH (2004) A descriptive correlational study of bacterial vaginosis in pregnancy and its association with preterm birth: implications for advanced practice nurses. J Am Acad Nurse Pract 16:555-60

    Article  PubMed  Google Scholar 

  18. McKhann G, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 34:939-44

    CAS  PubMed  Google Scholar 

  19. Morris J (1993) The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology 43:2412-414

    CAS  PubMed  Google Scholar 

  20. Morris J, McKeel D, Fulling K, Torack RM, Berg L (1988) Validation of clinical diagnostic criteria for Alzheimer's disease. Ann Neurol 24:17-2

    Article  CAS  PubMed  Google Scholar 

  21. Mosconi L, Tsui WH, De Santi S, Li J, Rusinek H, Convit A, Li Y, Boppana M, de Leon MJ (2005) Reduced hippocampal metabolism in MCI and AD: automated FDG-PET image analysis. Neurology 64:1860-867

    Article  CAS  PubMed  Google Scholar 

  22. Murphy DG, DeCarli C, McIntosh AR, Daly E, Mentis MJ, Pietrini P, Szczepanik J, Schapiro MB, Grady CL, Horwitz B, Rapoport SI (1996) Sex differences in human brain morphometry and metabolism: an in vivo quantitative magnetic resonance imaging and positron emission tomography study on the effect of aging. Arch Gen Psychiatry 53:585-94

    CAS  PubMed  Google Scholar 

  23. Perneczky R, Drzezga A, Diehl-Schmid J, Schmid G, Wohlschläger A, Kars S, Grimmer T, Wagenpfeil S, Monsch A, Kurz A (2006) Schooling mediates brain reserve in Alzheimer's disease: findings of FDG PET. J Neurol Neurosurg Psychiatry 77:1060-063 doi:10.1136/jnnp.2006.094714

    Article  CAS  PubMed  Google Scholar 

  24. Perneczky R, Wagenpfeil S, Komossa K, Grimmer T, Diehl J, Kurz A (2006) Mapping scores onto stages: minimental state examination and clinical dementia rating. Am J Geriatr Psychiatry 14:139-44

    Article  PubMed  Google Scholar 

  25. Poline JB, Worsley KJ, Evans AC, Friston KJ (1997) Combining spatial extent and peak intensity to test for activations in functional imaging. Neuroimage 5:83-6

    Article  CAS  PubMed  Google Scholar 

  26. Rabinowicz T, Dean DE, Petetot JM, de Courten-Myers GM (1999) Gender differences in the human cerebral cortex: more neurons in males; more processes in females. J Child Neurol 14:98-07

    Article  CAS  PubMed  Google Scholar 

  27. Rabinowicz T, Petetot JM, Gartside PS, Sheyn D, Sheyn T, de CM (2002) Structure of the cerebral cortex in men and women. J Neuropathol Exp Neurol 61:46-7

    PubMed  Google Scholar 

  28. Salehi A, Gonzalez Martinez V, Swaab DF (1998) A sex difference and no effect of ApoE type on the amount of cytoskeletal alterations in the nucleus basalis of Meynert in Alzheimer's disease. Neurobiol Aging 19:505-10

    Article  CAS  PubMed  Google Scholar 

  29. Sandberg G, Stewart W, Smialek J, Troncoso JC (2001) The prevalence of the neuropathological lesions of Alzheimer's disease is independent of race and gender. Neurobiol Aging 22:169-75

    Article  CAS  PubMed  Google Scholar 

  30. Sandberg O, Gustafson Y, Brannstrom B, Bucht G (1998) Prevalence of dementia, delirium and psychiatric symptoms in various care settings for the elderly. Scand J Soc Med 26:56-2

    CAS  PubMed  Google Scholar 

  31. Satz P (1993) Brain reserve capacity on symptom onset after brain injury: a formulation and review of evidence for threshold theory. Neuropsychology 7:273-95

    Article  Google Scholar 

  32. Staff RT, Murray AD,Deary IJ, Whalley LJ (2004) What provides cerebral reserve? Brain 127:1191-199

    Article  PubMed  Google Scholar 

  33. Talairach J,Tournoux P (1988) Coplanar stereotactical atlas of the human brain: 3-dimensional proportional system -an approach to cerebral imaging. Thieme Medical Publishers, New York

    Google Scholar 

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Correspondence to R. Perneczky MD.

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Perneczky, R., Drzezga, A., Diehl-Schmid, J. et al. Gender differences in brain reserve. J Neurol 254, 1395–1400 (2007). https://doi.org/10.1007/s00415-007-0558-z

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  • DOI: https://doi.org/10.1007/s00415-007-0558-z

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